Health care

Please discuss all West Papua health issues touched
upon below, in depth with an experienced doctor at your nearest specialized
travel advice center, so as to obtain personalized medical guidance tailored
to suit your specific health situation. Please remember also that only
first aid medical requisites are available while out in the field and
that in the event of serious illness or injury, appropriate medical help
must be summoned, and hence that treatment will be delayed until you can
be transported to a proper medical care facility. We strongly insist that
you conclude proper travel assistance insurance in your country of residence
before setting out to West Papua.

Preparing an overseas trip always provides a welcome
opportunity to verify whether your vaccinations for widespread diseases
such as tetanus, diphtheria and poliomyelitis are up to date. In addition,
immunization against hepatitis A plus B, Japanese encephalitis, rabies,
and typhoid fever are more or less recommended when embarking upon an
adventurous journey into West Papua's outback. Please be advised that,
whereas yellow fever is not endemic in Indonesia, vaccination against
it is formally required when entering Indonesia within six days from transiting
an infected area.

Malaria, including the potentially lethal cerebral Plasmodium
falciparum strain, clearly constitutes the primary potential health
hazard for visitors to West Papua. Since there is no 100 % effective anti-malarial
prophylaxis, the cornerstone of malaria prevention quite simply lies in
avoiding being bitten. The Anopheles mosquito, hosting the Plasmodium
parasite that ultimately causes an outbreak of malaria, bites exclusively
between dusk and dawn. At such time be sure to wear preferably light-colored
clothing, which covers your arms and legs as much as possible, and regularly
apply a high-quality repellent to the uncovered parts of your body. Always
sleep under a mosquito net, preferably impregnated with permethrine or
deltamethrine. It has been variously estimated that strict adherence to
these simple precautionary measures effectively reduces the risk of contracting
malaria by as much as 80-90 %. Additional prophylactic administration
of Malarone® will then increase your protection to in excess of 95
%, and is generally highly recommended for adventure travel into West
Papua.

Two widespread tropical and subtropical arthropod-borne
viral diseases have recently spread into West Papua, namely dengue fever
and chikungunya. Both illnesses are transmitted to humans by diurnally
biting Aedes mosquitoes, principally Aedes aegypti,
and develop similar symptoms including high fever, headache, measles-like
skin rash on trunk and less frequently limbs, and severe muscle and joint
pains. There are no vaccinations or specific treatments for either disease
and hence prevention from being bitten, through the same means as described
above for malaria, is critically important.

West Papua boasting the highest mountains between Himalaya
and Andes, it is also important to be aware of the risks associated with
going to and staying at high altitude. Acute Mountain Sickness (AMS) is
considered to be a neurological problem caused by changes in the central
nervous system as a result of insufficient adaptation to the low oxygen
pressure at high altitude. The occurrence of AMS is dependent upon the
elevation, the rate of ascent, and individual susceptibility. There are
no specific factors such as age, sex, or physical condition that correlate
with susceptibility to AMS. Any lowland resident can contract AMS when
staying for four to eight hours above 2,000 m elevation. While there is
only a 20 % chance of getting AMS when staying in areas between 2,000
and 2,500 m elevation, 75 % of people will have mild symptoms at elevations
over 3,000 m. Symptoms usually start 12-24 hours after arrival at altitude
and generally subside within two to four days as the body acclimatizes.
The symptoms of Mild AMS are headache, dizziness, fatigue, shortness of
breath, loss of appetite, nausea, disturbed sleep, and a general feeling
of malaise. Symptoms tend to be worse at night and when respiratory drive
is decreased. Mild AMS does not interfere with normal activity, and continued
stay at altitude and ascent at moderate rate are permitted. However, it
is essential that any symptoms of illness are promptly communicated so
that these may be monitored because Mild AMS may progress toward Moderate
or Severe AMS, High Altitude Pulmonary Edema (HAPE), and High Altitude
Cerebral Edema (HACE), all of which are life-threatening conditions.